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Gilmore D, Hand BN. Diabetes mellitus in privately insured autistic adults in the United States. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1785-1794. [PMID: 37886796 DOI: 10.1177/13623613231206421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
LAY ABSTRACT Diabetes is a chronic health condition that is challenging to manage. Estimates of how common diabetes is among non-autistic adults are available, but improved estimates for autistic adults are needed. The purpose of this study was to obtain improved diabetes estimates for autistic adults. We analyzed a large private health insurance claims database to estimate how common diabetes was among autistic adults, and how likely autistic adults were to have diabetes compared to non-autistic adults at 5-year age intervals throughout adulthood (e.g. 18-22, 23-27). We found that diabetes was more common among autistic adults than non-autistic adults and that autistic adults were significantly more likely than non-autistic adults to have diabetes throughout most of adulthood. Our findings suggest that autistic adults may be more likely than non-autistic adults to experience diabetes in adulthood. The development of diabetes support services and programs that accommodate autistic adults' individual needs are important for future study to promote positive diabetes outcomes for autistic adults.
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Hickey EJ, DaWalt LS, Hong J, Taylor JL, Mailick MR. Trajectories of Competitive Employment of Autistic Adults through Late Midlife. Healthcare (Basel) 2024; 12:265. [PMID: 38275545 PMCID: PMC10815573 DOI: 10.3390/healthcare12020265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/02/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Autistic adults experience challenges in maintaining employment; however, little is known about patterns of competitive employment through late midlife. This longitudinal study examined the change in hours of competitive employment for a cohort of autistic adults over a 22-year period. The study's aims were to provide a fine-grained analysis of competitive employment patterns, to determine whether there was age-related change, and to test whether trajectories differed between those with and without intellectual disability (ID). Using an accelerated longitudinal design, trajectories of hours of competitive employment were estimated from young adulthood through late midlife in a community-based cohort (n = 341; 1327 observations). Results indicated a significant curvilinear trajectory of age-related change in hours of competitive employment, with differences between those with and without ID. For those without ID, the number of competitive employment hours increased from young adulthood until early midlife, then leveled off and decreased into late midlife. For those with ID, engagement in competitive employment was low throughout. Although competitive employment is just one option for vocational engagement, it is a goal often articulated by autistic adults who seek entry into the general workforce. The present research reveals their degree of engagement in the competitive workforce across the decades of adulthood.
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Affiliation(s)
- Emily J. Hickey
- University Center for Excellence in Developmental Disabilities, Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705, USA;
| | - Leann Smith DaWalt
- University Center for Excellence in Developmental Disabilities, Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705, USA;
| | - Jinkuk Hong
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705, USA; (J.H.); (M.R.M.)
| | - Julie Lounds Taylor
- Pediatrics and Psychiatry & Behavioral Science, Vanderbilt University Medical Center, 1211 Medical Center Dr., Nashville, TN 37232, USA;
| | - Marsha R. Mailick
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705, USA; (J.H.); (M.R.M.)
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Bury SM, Hedley D, Uljarević M, Li X, Stokes MA, Begeer S. Employment profiles of autistic people: An 8-year longitudinal study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231225798. [PMID: 38243409 DOI: 10.1177/13623613231225798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
LAY ABSTRACT Autistic adults experience difficulties finding and keeping employment. However, research investigating reasons that might explain this difficulty produce mixed results. We gave a survey to 2449 autistic adults and used a statistic method to group them based on their employment status over 8 years. We identified four employment groups that best captured the experiences of autistic adults; this included a group that experienced stable unemployment, a group that experienced stable employment, a group that had high employment that reduced over time, and a group whose employment increased over the 8 years. Further analysis showed that those with fewer autistic traits, younger age, male gender, higher education, later diagnosis age and no co-occurring conditions were more likely to have stable employment. People whose employment changed over time were more likely to have a higher level of education than the stable unemployment group, and those in the increasing employment group were younger age and had no co-occurring conditions. These findings help us better understand that not all autistic adults' experiences of employment are the same, which helps focus where employment programmes and support may be most needed, for example, people who identify as women or have a co-occurring condition.
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Affiliation(s)
| | | | - Mirko Uljarević
- The University of Melbourne, Australia
- Stanford University, USA
| | - Xia Li
- La Trobe University, Australia
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Teh SE, Vo LTV, Bal VH. Factors that Influence the Daily Living Skills of Autistic Adults: The Importance of Opportunity. J Autism Dev Disord 2023:10.1007/s10803-023-06154-9. [PMID: 37914836 DOI: 10.1007/s10803-023-06154-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/03/2023]
Abstract
While existing literature has demonstrated that Daily Living Skills (DLS) performance of autistic individuals is lower than what is expected of their age and cognitive abilities, limited studies have examined DLS in autistic adults. This study aimed to understand the influence of intellectual function (IQ) and contextual factors (i.e., provision of opportunities) on autistic individuals' DLS performance. Participants included 33 autistic individuals ranging in age from 16 to 35 years. Their caregivers were administered the Vineland Adaptive Behavior Scales, 3rd edition's (Vineland-3) caregiver interview form. A novel coding system was developed to capture the frequency of reasons for participants' non-performance of DLS tasks, based on caregiver's report. "Target" scores reflecting expected possible score if reasons for nonperformance could be addressed were computed. Qualitative analysis of parental responses indicated that, for adults with average or higher IQ, lack of opportunity to learn and/or implement the skill was the most frequent reason for not performing DLS. Lack of opportunity was also the second most common reason provided for adults with NVIQ below 85, following cognitive ability. Taking into account reasons for nonperformance, "Target" scores were, on average, 7.65 points higher for the NVIQ ≥ 85 group. These findings highlight a need for multi-dimensional assessment to go beyond individual strengths and difficulties to also include contextual factors that may influence adults' skill acquisition and performance. It is essential that clinicians ensure that adequate opportunities for learning and performance are available to promote acquisition of important DLS.
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Affiliation(s)
- Shin Er Teh
- Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, New Brunswick, NJ, USA
| | - Le Thao Vy Vo
- Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, New Brunswick, NJ, USA
- Western New England University, Springfield, MA, USA
- Rutgers Center for Adult Autism Services, New Brunswick, NJ, 08901, USA
| | - Vanessa H Bal
- Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, New Brunswick, NJ, USA.
- Rutgers Center for Adult Autism Services, New Brunswick, NJ, 08901, USA.
- Applied Psychology, 604 Allison Road, Piscataway, NJ, 08854, USA.
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Mohammad S, de Ruijter MJT, Rukh G, Rask-Andersen M, Mwinyi J, Schiöth HB. Well-being spectrum traits are associated with polygenic scores for autism. Autism Res 2023; 16:1891-1902. [PMID: 37602645 DOI: 10.1002/aur.3011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/29/2023] [Indexed: 08/22/2023]
Abstract
Individuals with autism spectrum disorder (ASD) tend to experience lower well-being as demonstrated mostly for children and adolescents in epidemiological studies. A further investigation of inclusive well-being, in terms of five well-being spectrum (5-WBS) traits including neuroticism, depression, loneliness, life satisfaction, and positive affect, among adults with ASD may deepen our understanding of their well-being, and lead to the possibility to further modify societal supportive mechanisms for individuals with ASD. This study aims to investigate if a genetic predisposition for ASD is associated with 5-WBS traits using polygenic risk score (PRS) analysis. PRS for ASD were calculated based on the latest genome-wide association study of ASD by the Psychiatric Genetics Consortium (18,381 cases, 27,969 controls) and were created in the independent cohort UK Biobank. Regression analyses were performed to investigate the association between ASD PRS and 5-WBS traits in the UK Biobank population including 337,423 individuals. ASD PRS were significantly associated with all 5-WBS traits, showing a positive association with the negative WBS traits, neuroticism (max R2 = 0.04%, p < 1 × 10-4 ), depression (max R2 = 0.06%, p < 1 × 10-4 ), loneliness (max R2 = 0.04%, p < 1 × 10-4 ), and a negative association with the positive WBS traits, life satisfaction (max R2 = 0.08%, p < 1 × 10-4 ), positive affect (max R2 = 0.10%, p < 1 × 10-4 ). The findings suggest that adults carrying a high load of risk single nucleotide peptides (SNPs) for ASD are more likely to report decreased well-being. The study demonstrates a considerable connection between susceptibility to ASD, its underlying genetic etiology and well-being.
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Affiliation(s)
- Salahuddin Mohammad
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Markus J T de Ruijter
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Gull Rukh
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Mathias Rask-Andersen
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Jessica Mwinyi
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
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Schiltz HK, Clarke E, Rosen N, De La Rosa SG, Masjedi N, Christopher K, Lord C. A Longitudinal Mixed-Methods Characterization of Family Support from Adolescence to Young Adulthood in Autism and Other Developmental Disabilities. J Autism Dev Disord 2023:10.1007/s10803-023-06070-y. [PMID: 37668851 DOI: 10.1007/s10803-023-06070-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 09/06/2023]
Abstract
Although caregiving responsibilities and need for support persist and evolve across the life course in families with autistic youth or youth with other developmental disabilities (DDs), little is known about support during their child's adulthood years. Therefore, the present study used a mixed-methods approach to examine change and stability in formal and informal family support across the transition to adulthood. Caregivers of 126 individuals with autism or DDs completed a modified version of the Family Support Scale, including open-ended questions, at five time points from adolescence (age 16) into young adulthood (age 22). Caregivers reported that informal support from family members was the most frequently used, helpful, and valued source of support with relative stability across time. In contrast, the reported helpfulness, use, and value of formal support (e.g., professionals, schools) for caregivers declined over time. Qualitative content analyses revealed characteristics of highly valued support included support type (e.g., instrumental or emotional) and features of the support source (e.g., their understanding). There was a shift to valuing emotional support more than instrumental support over time, especially for caregivers of less able adults. Partnership and dependability emerged as highly valued features of the support source. These findings fit within a social convoy perspective and likely reflect the "service cliff" experienced by autistic individuals or people with DDs and their families. As social networks shrink over time and formal services are less readily available in adulthood, remaining sources of support, particularly from family members, become increasingly important.
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Affiliation(s)
- Hillary K Schiltz
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.
| | - Elaine Clarke
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Nicole Rosen
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Sofi Gomez De La Rosa
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Nina Masjedi
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Kourtney Christopher
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
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Tincani M, Ji H, Upthegrove M, Garrison E, West M, Hantula D, Vucetic S, Dragut E. Vocational Interventions for Individuals with ASD: Umbrella Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2023. [DOI: 10.1007/s40489-023-00368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Forbes G, Kent R, Charman T, Baird G, Pickles A, Simonoff E. How do autistic people fare in adult life and can we predict it from childhood? Autism Res 2023; 16:458-473. [PMID: 36519265 PMCID: PMC10947100 DOI: 10.1002/aur.2868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/26/2022] [Indexed: 12/23/2022]
Abstract
This study describes social, mental health, and quality of life outcomes in early adulthood, and examines childhood predictors in the Special Needs and Autism Project (SNAP), a longitudinal population-based cohort. Young autistic adults face variable but often substantial challenges across many areas of life. Prediction of outcomes is important to set expectations and could lead to the development of targeted early intervention. Autistic children were enrolled at age 12 and parents reported outcomes 11 years later when their children were age 23 (n = 121). Thirty six percent of autistic adults were in competitive employment or education and 54% had frequent contact with friends. Only 5% of autistic adults were living independently, and 37% required overnight care. Moderate or severe anxiety and depression symptoms were found for 11% and 12% of young adults, respectively. Subjective quality of life was similar to UK averages except for social relationships. Using childhood IQ, autism traits and adaptive functioning meaningful predictions can be made of living situation, employment and education and physical health. Prediction was poor for friendships, mental health outcomes and other aspects of quality of life. Our results suggest that although young autistic adults face challenges across normative, social outcomes, they may be faring better in regard to mental health or quality of life. Childhood IQ, autism traits and adaptive functioning are most useful for predicting outcomes. After accounting for these factors, childhood measurements of behavioral and emotional problems and language offered little improvement in prediction of adult outcomes.
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Affiliation(s)
- Gordon Forbes
- Department of Biostatistics and Health Informatics London, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
| | - Rachel Kent
- Department of Child and Adolescent Psychiatry, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Tony Charman
- Department of Psychology, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
| | | | - Andrew Pickles
- Department of Biostatistics and Health Informatics London, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- NIHR Maudsley Biomedical Research Centre at South LondonMaudsley NHS Foundation Trust and King's CollegeLondonUK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- NIHR Maudsley Biomedical Research Centre at South LondonMaudsley NHS Foundation Trust and King's CollegeLondonUK
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9
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Schwartz AE, Corey J, Duff J, Herer A, Rogers ES. Anticipating the outcomes: how young adults with developmental disabilities and co-occurring mental health conditions make decisions about disclosure of their mental health conditions at work. Disabil Rehabil 2023; 45:602-612. [PMID: 35152805 DOI: 10.1080/09638288.2022.2037749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE Little is known about how young adults (YA) with developmental disabilities (DD) and co-occurring mental health conditions navigate workplace disclosure of their mental health condition(s). We sought to understand the guidance professionals provide regarding disclosure and the decisions YA makes about disclosure of mental health conditions. METHODS We conducted focus groups with professionals who support YA with DD to attain and maintain employment (n = 17) and individual interviews with YA with DD and co-occurring mental health conditions (n = 12; DD diagnoses: autism, n = 9, other DD, n = 3). We conducted content analysis to identify why, when, what, and to whom YA disclose their mental health condition and guidance provided regarding disclosure. RESULTS YA and professionals described disclosure decisions as largely influenced by perceived needs (i.e., need for accommodations) and anticipated positive (e.g., support) and negative (e.g., stigma, not being hired) outcomes. They largely constrained disclosure to work-relevant content. Many YA disclosed to coworkers with whom they were comfortable, though both YA and professionals agreed that initial disclosure should be limited to supervisors and/or human resources. CONCLUSIONS Workplaces may support disclosure-a necessity for the provision of accommodations-by cultivating an inclusive environment and openly demonstrating familiarity and comfort with employees with disabilities.IMPLICATIONS FOR REHABILITATIONProfessionals who support young adults with developmental disabilities and co-occurring mental health conditions should be well-versed in current laws and regulations on disclosure and reasonable workplace accommodations.Workplace culture is one major factor impacting how disclosure is handled, including whether the disclosure is required at all.Individuals with disabilities and professionals should recognize that timing, content, and decisions to disclose may vary by individuals' needs and workplace supports, and that change may occur over time.
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Affiliation(s)
- Ariel E Schwartz
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | | | | | | | - E Sally Rogers
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
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Broda MD, Bogenschutz M, Lineberry S, Dinora P, Prohn S, West A. Comparing employment, employment services, and employment goals in propensity-matched samples of people with intellectual and developmental disabilities with and without autism. JOURNAL OF VOCATIONAL REHABILITATION 2023; 58:10.3233/jvr-230019. [PMID: 38528971 PMCID: PMC10961952 DOI: 10.3233/jvr-230019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background People with intellectual and developmental disabilities (IDD) tend to have poor employment outcomes relative to the general population, as do people with autism. Research is unclear, however, about how people with IDD with and without autism compare on a variety of employment-related indicators, including desire to work, having work as a goal in their service plans, and being employed. Objectives To understand how people with IDD with and without autism compare on important employment related outcomes, based on a matched random sample. Methods Using merged administrative datasets, we used propensity score matching to construct statistically proximate samples of Medicaid waiver users in a single state with IDD both with and without autism, and then tested differences between the two groups on important employment-related indicators. Results People with IDD and autism were less likely than people with IDD alone to have a goal for employment in their individualized service plans and to hold employment in group community settings. There was no statistical difference between the two groups in terms of desire to have a job or employment in individual community settings. Conclusions Results reinforce the importance of planning for employment if holding employment is a person's aim, regardless of the presence of autism.
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Affiliation(s)
- Michael D Broda
- Virginia Commonwealth University, Department of Foundations of Education, 1015 W. Main Street, Richmond, VA, USA 23284-2020
| | | | - Sarah Lineberry
- School of Social Work, Virginia Commonwealth University, Virginia, USA
| | - Parthenia Dinora
- Partnership for People with Disabilities, Virginia Commonwealth University, Virginia, USA
| | - Seb Prohn
- Partnership for People with Disabilities, Virginia Commonwealth University, Virginia, USA
| | - Angela West
- Partnership for People with Disabilities, Virginia Commonwealth University, Virginia, USA
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Schutz MA, Schwartzman B, Awsumb JM, Burgess L, Carter EW, Taylor JL. Pathways to paid work for youth with severe disabilities: Perspectives on strategies for success. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND: Paid work during high school serves as a steppingstone to postsecondary employment for young adults with severe disabilities. Yet youth with significant cognitive impairments rarely have the opportunity to experience paid work during high school. OBJECTIVE: The purpose of this study was to identify the range of facilitators that promote paid employment for youth with severe disabilities during high school. METHODS: We conducted individual and focus group interviews with 74 special educators, adult agency providers, school district leaders, family members of youth with severe disabilities, and local employers. RESULTS: Participants discussed 36 facilitators spanning nine major categories: collaboration, training and information, attitudes and mindsets, supports for youth, youth work experiences, knowledge and skill instruction, staffing, individualization, and transportation. We identified similarities and differences in the factors emphasized by each of the five stakeholder groups. CONCLUSION: Renewed attention should be focused on key practices and partnerships needed to facilitate community-based work experiences for youth with severe disabilities prior to graduation.
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Affiliation(s)
| | - Ben Schwartzman
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Jessica M. Awsumb
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Leah Burgess
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Erik W. Carter
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
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Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. NATURE REVIEWS PSYCHOLOGY 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum’s capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives. The focus on functional deficits in conventional autism research constrains understanding of autistic lives. In this Review, Pellicano et al. appraise research on autistic adulthood through a capabilities lens to identify areas where autistic adults thrive, and where more research and services are needed to enhance their quality of life.
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Taubner H, Tideman M, Staland Nyman C. Employment Sustainability for People with Intellectual Disability: A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:353-364. [PMID: 34958449 PMCID: PMC9576651 DOI: 10.1007/s10926-021-10020-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Purpose Previous reviews about employment for people with intellectual disability (ID) have left questions about employment sustainability unanswered. Therefore, the aim of this systematic review was to identify and analyse research regarding employment sustainability for people with ID. The research questions were: What research about employment sustainability for people with ID has been published internationally between 2010 and 2020? In the identified studies, how is employment sustainability defined and measured and what are the main findings regarding employment sustainability? Methods A systematic review was conducted using eight databases from various disciplines including medical, health, and social sciences. After a selection process, 10 articles remained, and a framework matrix was created to analyse them. An employment sustainability definition was used as an analytical tool. Results Ten articles were identified as being about employment sustainability for people with ID. Five of them used qualitative designs and five used quantitative designs. Only four out of ten contained a definition of employment sustainability, and there was an inconsistency in measurement methods. The reported findings in the studied articles were categorised into three types: proportions of long-term employed individuals within the studied population, facilitators and barriers to long-term employment. Conclusions There is only a limited amount of research about employment sustainability for people with ID. Nevertheless, a few facilitators and barriers could be identified. There is no consensus about how to define or measure employment sustainability, making comparisons difficult.
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Affiliation(s)
- Helena Taubner
- School of Health and Welfare, Halmstad University, Box 823, 301 18, Halmstad, Sweden.
| | - Magnus Tideman
- School of Health and Welfare, Halmstad University, Box 823, 301 18, Halmstad, Sweden
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Carin Staland Nyman
- School of Health and Welfare, Halmstad University, Box 823, 301 18, Halmstad, Sweden
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14
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Tomaszewski B, Klinger LG, Pugliese CE. Self-Determination in Autistic Transition-Aged Youth without Intellectual Disability. J Autism Dev Disord 2022; 52:4067-4078. [PMID: 34536165 PMCID: PMC8930783 DOI: 10.1007/s10803-021-05280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
Self-determination refers to an individual's capacity and opportunities to act as a causal agent in their own lives to make choices, decisions, and set goals. The current study examined self- and parent-reports of the AIR Self-Determination Scale in transition-aged autistic youth (Based on stakeholder preferences, we use identity-first(autistic) or neutral language (on the autism spectrum) (Bottema-Beutel in JAMA 3:18-29, 2020)). Autistic youth completed depression and executive function measures, and parents rated their child's social-communication and executive function difficulties. Despite differences between youth and parent reports, both youth and their parents reported lower self-determination skills (capacity) than opportunities to practice self-determined behaviors. Both depression and executive function skills were related to self-determination capacity, highlighting potential intervention targets for transition-aged youth to facilitate increased self-determination and potentially improved adult outcomes.
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Affiliation(s)
- Brianne Tomaszewski
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, CB#7180, Chapel Hill, NC, 27599-7180, USA.
| | - Laura G Klinger
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, CB#7180, Chapel Hill, NC, 27599-7180, USA
| | - Cara E Pugliese
- Center for Autism Spectrum Disorders, Division of Pediatric Neuropsychology, Children's Research Institute, Children's National Hospital, Washington, USA
- Department of Psychiatry, Behavioral Sciences & Pediatrics, The George Washington University School of Medicine, 15245 Shady Grove Rd., Suite 350, Rockville, MD, 20850, USA
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Schwartzman JM, Corbett BA. Depression and Employment Outcomes in Autistic Adults: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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16
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Travers BG, Lee L, Klans N, Engeldinger A, Taylor D, Ausderau K, Skaletski EC, Brown J. Associations Among Daily Living Skills, Motor, and Sensory Difficulties in Autistic and Nonautistic Children. Am J Occup Ther 2022; 76:23206. [PMID: 35171982 PMCID: PMC9563082 DOI: 10.5014/ajot.2022.045955] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Motor and sensory challenges are commonly reported among autistic individuals and have been linked to challenges with daily living skills (DLS). To best inform clinical intervention, greater specificity in how sensory and motor challenges relate to DLS is needed. OBJECTIVE To evaluate the relationship between combined sensory and motor scores and DLS performance among autistic and nonautistic children and to explore associations between motor scores and performance on specific DLS items. DESIGN Descriptive design. SETTING University research lab. PARTICIPANTS Autistic children, nonautistic children with no family history of or diagnosis related to autism, and nonautistic children with a family history of or diagnosis related to autism (ages 6-10 yr; N = 101). All participants communicated verbally. INTERVENTION None. Outcomes and Measures: Parent-report measures of DLS and sensory features and standardized assessments of motor performance. RESULTS Findings indicated a strong relationship between motor difficulties and all domains of DLS. At the item level, motor skills were associated with occupations of dressing, bathing, health management, cleaning up and organization, meal preparation and clean-up, education, and safety. Combined sensory and motor measures better predicted DLS than sensory or motor measures alone. CONCLUSIONS AND RELEVANCE Children with motor and sensory challenges are likely to experience challenges with a diversity of occupations, which is important given the prevalence of motor and sensory challenges among autistic children and among children with other neurodevelopmental conditions. Therapeutic interventions that account for or address these motor challenges and associated sensory features are likely to further enhance DLS. What This Article Adds: A combination of motor challenges and sensory features better predict DLS than either motor or sensory challenges alone. In addition, motor challenges in children are most highly associated with DLS challenges in the domains of dressing, bathing, cleaning, education, safety, health, and meal preparation. Occupational therapists can use this information when considering how the results of sensory and motor assessment may guide clinical intervention in autistic and nonautistic children.
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Affiliation(s)
- Brittany G Travers
- Brittany G. Travers, PhD, is Associate Professor, Occupational Therapy Program, Department of Kinesiology, and Investigator, Waisman Center, University of Wisconsin-Madison;
| | - Lucia Lee
- Lucia Lee, MOT, OTR/L, is Occupational Therapist, Froedtert Hospital, Milwaukee, WI
| | - Nicole Klans
- Nicole Klans, MOT, OTR/L, is Occupational Therapist, Children's Minnesota, Minneapolis
| | - Alexandra Engeldinger
- Alexandra Engeldinger, MOT, OTR/L, is Occupational Therapist, Aspire Therapy and Development Services, Madison, WI
| | - Desiree Taylor
- Desiree Taylor, MOT, OTR/L, is Doctoral Student, Occupational Therapy Program, Department of Kinesiology, University of Wisconsin-Madison, and Occupational Therapist, Aspire Therapy & Development Services, Madison, WI
| | - Karla Ausderau
- Karla Ausderau, PhD, OTR/L, is Associate Professor, Occupational Therapy Program, Department of Kinesiology, and Investigator, Waisman Center, University of Wisconsin-Madison
| | - Emily C Skaletski
- Emily C. Skaletski, MOT, OTR/L, is PhD Student, Occupational Therapy Program, Department of Kinesiology, and Member, Motor and Brain Development Lab, Waisman Center, University of Wisconsin-Madison
| | - Joshua Brown
- Joshua Brown, OTD, OTR/L, is Clinical Assistant Professor, Occupational Therapy Program, Department of Kinesiology, University of Wisconsin- Madison
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17
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Hutchinson C, Lay K, Alexander J, Ratcliffe J. Perspectives on people with intellectual disabilities as business owners. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Microenterprise is emerging as an employment pathway for people with intellectual disabilities, but there is little published research in this area. OBJECTIVE: To identify the facilitators, barriers and outcomes from microenterprises owned by people with intellectual disabilities from several stakeholder perspectives. METHODS: Semi-structured interviews were conducted with seven business owners and 22 other stakeholders with data analysed using content analysis. RESULTS: A key facilitator for successful microenterprise was the availability of, and continued access to, three pillars of formal support (microenterprise consultant, personal assistant, and an enterprise management group). Key barriers identified were funding limitations, role confusion between supports, and problems recruiting supports with business skills. Outcomes for business owners included personal/emotional growth, skills development, autonomy, having a meaningful role, and contributing to their communities. Other stakeholders experienced personal rewards and an increased expectation of the capacities of people with intellectual disabilities. Income generation and cessation of benefits was not the goal of the model or noted as a main consideration by stakeholders. CONCLUSIONS: Microenterprise can provide people with intellectual disabilities with an employment pathway highly tailored to their goals, capacities and interests. With consistent formal support, people with intellectual disabilities can run businesses over many years.
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Affiliation(s)
- Claire Hutchinson
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Kiri Lay
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - June Alexander
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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18
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Ward-Sutton C, Manyibe EO, Lewis AN, Lequerica AH, Fyffe D, Moore CL, Kwan N, Wang N, O'Neil J. Assistive Technology Workplace Accommodation and Employment among Diverse Populations with Disabilities: Does Race/Ethnicity Matter? JOURNAL OF REHABILITATION 2022; 88:23-25. [PMID: 38528876 PMCID: PMC10961985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
The purpose of this study was to examine the relationship between assistive technology workplace accommodation (AT-WA) usage and employment status among racial/ethnic populations with disabilities. Chi-square tests and logistic regression were used to analyze secondary data from the 2015 Kessler Foundation National Employment and Disability Survey (KFNEDS). Results indicated that significantly more consumers who used AT-WA were currently working, and a significantly greater proportion of them were White. Moreover, a significantly lower proportion of those who did not use AT-WA had less expected odds of being currently employed. Specific implications are discussed to inform practices, policy, and/or future research.
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Abstract
Over the past four decades there have been significant advances in our understanding of autism, yet services for autistic adults continue to lag far behind those for children, and prospects for employment and independent living remain poor. Adult outcomes also vary widely and while cognitive and language abilities are important prognostic indicators, the influence of social, emotional, familial and many other factors remains uncertain. For this special issue marking the 40th anniversary of DSM-III, the present paper describes the changing perspectives of autism in adulthood that have occurred over this period, explores individual and wider environmental factors related to outcome, and suggests ways in which services need to be changed to improve the future for adults living with autism.
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Affiliation(s)
- Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
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20
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Broda MD, Bogenschutz M, Dinora P, Prohn SM, Lineberry S, Ross E. Using Machine Learning to Predict Patterns of Employment and Day Program Participation. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:477-491. [PMID: 34700349 DOI: 10.1352/1944-7558-126.6.477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/16/2021] [Indexed: 06/13/2023]
Abstract
In this article, we demonstrate the potential of machine learning approaches as inductive analytic tools for expanding our current evidence base for policy making and practice that affects people with intellectual and developmental disabilities (IDD). Using data from the National Core Indicators In-Person Survey (NCI-IPS), a nationally validated annual survey of more than 20,000 nationally representative people with IDD, we fit a series of classification tree and random forest models to predict individuals' employment status and day activity participation as a function of their responses to all other items on the 2017-2018 NCI-IPS. The most accurate model, a random forest classifier, predicted employment outcomes of adults with IDD with an accuracy of 89 percent on the testing sample, and 80 percent on the holdout sample. The most important variable in this prediction was whether or not community employment was a goal in this person's service plan. These results suggest the potential machine learning tools to examine other valued outcomes used in evidence-based policy making to support people with IDD.
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Affiliation(s)
- Michael D Broda
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Matthew Bogenschutz
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Parthenia Dinora
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Seb M Prohn
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Sarah Lineberry
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Erica Ross
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
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21
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Cheriyan C, Shevchuk-Hill S, Riccio A, Vincent J, Kapp SK, Cage E, Dwyer P, Kofner B, Attwood H, Gillespie-Lynch K. Exploring the Career Motivations, Strengths, and Challenges of Autistic and Non-autistic University Students: Insights From a Participatory Study. Front Psychol 2021; 12:719827. [PMID: 34744884 PMCID: PMC8568013 DOI: 10.3389/fpsyg.2021.719827] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
Supports for the growing number of autistic university students often focus on helping them succeed in university. However, even educated autistic people experience discrimination and other challenges which can make it very difficult for them to obtain meaningful jobs. Little remains known about how universities can better support their autistic students and alumni in overcoming barriers to meaningful employment. In this participatory study, a team of autistic and non-autistic researchers asked autistic (n = 92) and non-autistic (n = 774) university students about their career aspirations, strengths they believe will help them succeed in their "dream jobs," and obstacles they expect to encounter. Autistic participants' top goal in attending college was to improve their career prospects. However, relatively few autistic students reported learning career-specific skills at university. Autistic students were more likely to seek an academic job and less likely to seek a career in healthcare than non-autistic students. Autistic students highlighted writing skills and detail orientation as strengths that could help them succeed in their dream jobs more often than non-autistic students. However, they were also more likely to expect discrimination, social, and psychological difficulties to stand in the way of their dream jobs. These findings suggest that universities should prioritize experiential learning opportunities to help autistic (and non-autistic) students develop employment-related skills while providing mental health supports. Universities should demonstrate their commitment to supporting diverse learners by seeking out and hiring autistic professionals and by teaching their own staff and employers how to appreciate and support autistic colleagues.
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Affiliation(s)
- Chinnu Cheriyan
- College of Staten Island, The City University of New York, Staten Island, NY, United States
| | - Sergey Shevchuk-Hill
- College of Staten Island, The City University of New York, Staten Island, NY, United States
| | - Ariana Riccio
- The Graduate Center, The City University of New York, New York, NY, United States
| | - Jonathan Vincent
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Steven K. Kapp
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | - Eilidh Cage
- Department of Psychology, University of Stirling, Stirling, United Kingdom
| | - Patrick Dwyer
- Center for Mind and Brain, University of California, Davis, Sacramento, CA, United States
| | - Bella Kofner
- College of Staten Island, The City University of New York, Staten Island, NY, United States
| | - Helen Attwood
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Kristen Gillespie-Lynch
- College of Staten Island, The City University of New York, Staten Island, NY, United States
- The Graduate Center, The City University of New York, New York, NY, United States
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22
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Shea LL, Cooper D, Wilson AB. Preventing and improving interactions between autistic individuals and the criminal justice system: A roadmap for research. Autism Res 2021; 14:2053-2060. [PMID: 34402601 DOI: 10.1002/aur.2594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/06/2022]
Abstract
Researchers have identified that autistic individuals are encountering the criminal justice system as victims, offenders, and witnesses at high rates. The prevalence of autism spectrum disorder (ASD) is increasing and generating a comprehensive approach to addressing criminal justice system involvement among autistic individuals is a timely and urgent need. Revisions to an established framework generated for use among individuals with mental health diagnoses, the sequential Intercept Model (SIM), were produced by an international consortium of interdisciplinary stakeholders presenting a new opportunity to identify gaps in ASD research and generate preventive solutions across the criminal justice system. The revised SIM maps each criminal justice system component, or Intercept, and includes paths for the experiences of autistic individuals as victims or witnesses to crimes as well as offenders to catalyze new and interdisciplinary research, policy, and practice efforts. As the field of ASD research continues to grow, the revised SIM is a promising pathway to avoiding siloed research approaches, including diverse autistic voices, and contributing to international dialogue about criminal justice reform at a critical juncture. LAY SUMMARY: Autistic individuals are encountering the criminal justice system as victims, offenders, and witnesses at high rates. A revised version of the SIM generated by an international consortium provides a cohesive framework to ensure research focused on this topic extends across the criminal justice system. Preventing and improving interactions between autistic individuals and the criminal justice system is an urgent research, policy, and practice need.
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Affiliation(s)
- Lindsay Lawer Shea
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Dylan Cooper
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amy Blank Wilson
- School of Social Work, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
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23
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Schwartz AE, Rogers ES, Russinova Z. Predictors of community-based employment for young adults with intellectual disability and co-occurring mental health conditions. Disabil Rehabil 2021; 44:1609-1618. [PMID: 34011223 DOI: 10.1080/09638288.2021.1907457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To identify predictors of community-based employment and employment quality for young adults ages 23-30 with intellectual disability and co-occurring mental health conditions (YA-ID-MH). METHODS We conducted secondary analysis of the 2017-2018 National Core Indicators® (NCI®) In-Person Survey. The NCI® survey was conducted in 35 states and Washington DC. Participants: YA with ID, ages 23-30 who had complete data. We conducted multiple regression analyses to examine demographic and environmental predictors of community-based employment, in addition to employment quality indicators: hourly wages, hours worked, and job duration. We also descriptively examined job satisfaction. RESULTS YA-ID-MH were somewhat less likely to be employed per record review and self-report than YA with ID only, but these findings did not reach statistical significance. On average, YA with ID only had higher hourly wages and worked more hours than those with ID-MH, but there were no significant differences in job duration. For YA-ID-MH, predictors of employment included gender, race, level of ID, and residential setting. Multiple demographic and environmental factors predicted employment quality. CONCLUSIONS YA-ID-MH experience employment disparities compared to YA with ID only. Service providers should specifically attend to those at the highest risk of unemployment/low quality employment.IMPLICATIONS FOR REHABILITATIONYoung adults with intellectual/developmental disabilities and co-occurring mental health conditions (ID-MH) experience employment disparities.Young adults with ID-MH who are non-white and female may have particularly low employment rates and employment quality.Societal-level interventions to address racial and gender-based bias may support individuals with ID-MH to acquire and maintain jobs by addressing disparities in social networks/social capital and ensuring equitable service provision and supports for those at the highest risk for unemployment.Policy makers should consider additional funding for employment services for transition-age youth with ID-MH, particularly those from marginalized populations.
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Affiliation(s)
- Ariel E Schwartz
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | - E Sally Rogers
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | - Zlatka Russinova
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
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24
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Kirby AV, Feldman KJC, Himle MB, Diener ML, Wright CA, Hoffman JM. Pilot Test of the Maximizing Adolescent Post-Secondary Success (MAPSS) Intervention: Supporting Parents of Autistic Youth. Am J Occup Ther 2021; 75:12504. [PMID: 34781348 PMCID: PMC8095705 DOI: 10.5014/ajot.2021.045815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Parents play an essential role in the transition to adulthood for autistic youth, yet often feel they do not have adequate training and resources. OBJECTIVE To evaluate data on the preliminary efficacy of and collect participant feedback about the Maximizing Adolescent Post-Secondary Success (MAPSS) intervention. DESIGN Single-group, pretest-posttest pilot study. SETTING Clinic. PARTICIPANTS Twenty-two families of autistic youth (ages 13-19 yr, 72.7% male). INTERVENTION MAPSS is a group intervention for parent-youth dyads that is designed to guide parents in facilitating the development of independent skills for adulthood. Outcomes and Measures: Measures included the Transition Preparation Activities Measure (T-PAM), Family Empowerment Scale (FES), 10-item Perceived Stress Scale (PSS-10), Adulthood Expectations Questionnaire (AEQ), Adaptive Behavior Assessment System-Third Edition (ABAS-3), and a study-specific participant feedback survey. RESULTS Frequency of transition preparation activities (T-PAM) significantly increased from before to after the intervention, and although the frequency of preparation activities decreased by 1-mo follow-up, it remained significantly higher than at baseline. Parent self-efficacy (FES), parent expectations (AEQ), and parent sense of control over outcomes (AEQ) also significantly increased from preintervention to follow-up; however, parent coping (PSS-10) was unchanged. Youth self-care skills (ABAS-3) demonstrated improvements 6 mo after the completion of the intervention, although other areas of adaptive behavior did not significantly change. Feedback from parents suggested they had positive experiences and felt the intervention was beneficial. CONCLUSIONS AND RELEVANCE Our data suggest that the MAPSS intervention is an appropriate candidate for larger, controlled clinical trials. What This Article Adds: With additional evidence, this intervention can offer guidelines for occupational therapists to work with autistic youth and their parents to prepare for adulthood.
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Affiliation(s)
- Anne V Kirby
- Anne V. Kirby, PhD, OTR/L, is Assistant Professor, Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City;
| | - Kristina J Cottle Feldman
- Kristina J. Cottle Feldman, PhD, is Clinical Instructor, Department of Psychiatry, University of Utah, Salt Lake City
| | - Michael B Himle
- Michael B. Himle, PhD, is Associate Professor, Department of Psychology, University of Utah, Salt Lake City
| | - Marissa L Diener
- Marissa L. Diener, PhD, is Professor, Department of Family and Consumer Studies, University of Utah, Salt Lake City
| | - Cheryl A Wright
- Cheryl A. Wright, PhD, is Professor, Department of Family and Consumer Studies, University of Utah, Salt Lake City
| | - Jenna M Hoffman
- Jenna M. Hoffman, MOT, OTR/L, is Occupational Therapist, Ensign Therapy Group, San Juan Capistrano, CA. Hoffman was Research Assistant, Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, at the time of the study
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25
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Marsack-Topolewski CN, Samuel PS, Tarraf W. Empirical evaluation of the association between daily living skills of adults with autism and parental caregiver burden. PLoS One 2021; 16:e0244844. [PMID: 33400706 PMCID: PMC7785247 DOI: 10.1371/journal.pone.0244844] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 12/18/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the joy of parenting, the burden of daily caregiving for children with autism spectrum disorders (ASD) can be overwhelming and constant. Parents can expect to provide enduring care for their children with ASD. Given that the majority of individuals with autism spectrum disorders (ASD) remain in their family homes well into adulthood, often the need for assistance with activities of daily living (ADLs) is placed on parents. Providing ongoing support to adult children who have difficulty with completing ADLs can increase parental caregiving demands. Therefore, the purpose of this study was to examine the relationship between the ability of adults with ASD to perform ADLs with parental perceptions of caregiver burden. METHODS Quantitative analysis of cross-sectional multi-state data gathered electronically using Qualtrics from 320 aging parents of adults with ASD was conducted. Regression models were fit to examine the association of ADL challenges with total caregiver burden and its four domains (emotional, financial, time dependence, and developmental). RESULTS Parental perceptions of caregiver burden decreased, particularly time dependence and developmental burden, when adult children were less dependent in ADLs, even after adjusting for parental health and behavioral challenges. CONCLUSIONS Findings support the need for family-centered interventions to improve the capacity of adults with ASD to perform ADLs independently.
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Affiliation(s)
| | - Preethy Sarah Samuel
- Occupational Therapy Program, Department of Health Care Sciences, Wayne State University, Detroit, Michigan, United States of America
| | - Wassim Tarraf
- Occupational Therapy Program, Department of Health Care Sciences, Wayne State University, Detroit, Michigan, United States of America
- Institute of Gerontology, Wayne State University, Detroit, Michigan, United States of America
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26
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Wehman P, Schall C, McDonough J, Sima A, Brooke A, Ham W, Whittenburg H, Brooke V, Avellone L, Riehle E. Competitive Employment for Transition-Aged Youth with Significant Impact from Autism: A Multi-site Randomized Clinical Trial. J Autism Dev Disord 2020; 50:1882-1897. [PMID: 30825082 DOI: 10.1007/s10803-019-03940-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study reports the results of a multi-site, parallel block randomized clinical trial to expand the previous findings regarding the implementation of Project SEARCH plus ASD Supports (PS + ASD) on employment outcomes upon graduation from high school. Participants were 156 individuals with significant impact from ASD between the ages of 18-21. There was a significant difference between treatment and control groups with 73.4% of the treatment group acquiring competitive employment at or above minimum wage by 1-year after graduation compared to 17% of the control group for whom data was provided. At 1-year, employed treatment group participants worked an average of 21.2 h per week (SD = 9) for a mean hourly wage of $9.61 per hour (SD = $1.55).Clinical Trial Registration: clinicaltrials.gov Identifier: NCT03560453.
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Affiliation(s)
- Paul Wehman
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.,Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Carol Schall
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA. .,School of Education, Virginia Commonwealth University, Richmond, VA, USA. .,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA.
| | - Jennifer McDonough
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Adam Sima
- Department of Biostatistics, Virginia Commonwealth University, Richmond, USA
| | - Alissa Brooke
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Whitney Ham
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Holly Whittenburg
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Valerie Brooke
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Lauren Avellone
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Erin Riehle
- Division of Disability Services, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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27
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Lord C, McCauley JB, Pepa LA, Huerta M, Pickles A. Work, living, and the pursuit of happiness: Vocational and psychosocial outcomes for young adults with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1691-1703. [PMID: 32431163 PMCID: PMC7541415 DOI: 10.1177/1362361320919246] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT It is important to better understand how adults with autism are functioning in adulthood. Studies that have tracked individuals across the lifespan can help identify developmental factors influence differences in adult outcomes. The present study examines the independence, well-being, and functioning of 123 adults that have been closely followed since early childhood. Autism diagnosis and cognitive assessments were given frequently throughout childhood and during adulthood. We examined differences between adults who had received an autism diagnosis at some point with higher cognitive abilities (Ever ASD-High IQ) and lower cognitive abilities (Ever ASD-Low IQ), as well as adults who never received a diagnosis of autism in the course of the study (Never ASD). We found that autistic features specifically related to adaptive skills and friendships, and verbal intelligence related to work outcomes. In many ways, the Never ASD group had similar outcomes compared to the ASD groups. However, adults with ASD tended to have lower well-being and fewer positive emotions. Families played a major role in supporting adults with and without ASD at all intellectual levels. The findings suggest that realistic ways of increasing independence need to be developed by working with adults and their families, while acknowledging the contribution of individual differences in mental health, intelligence and autism symptoms across neurodevelopmental disorders.
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28
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Long KA, Gordillo M, Orsmond GI. Improving the Validity and Generalizability of Adult Autism Research Through Incorporating Family and Cultural Contexts. AUTISM IN ADULTHOOD 2020; 2:177-184. [PMID: 32959029 DOI: 10.1089/aut.2019.0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The relatively nascent empirical knowledge base regarding autism in adulthood provides an opportunity to adopt a contextual approach that conceptualizes autism features, outcomes, and supportive services as interactions between the characteristics of the condition and contextual factors across the life course. Although a contextual approach encompasses many aspects of a person's identity and social ecology, we focus here on the closely interrelated family and cultural contexts, which have been poorly integrated into adult autism research. We argue that designing studies with a priori attention to context (e.g., family and culture) will improve the relevance and comprehensiveness of findings, which in turn will improve construct validity and provide a more accurate understanding of autism-related outcomes in adulthood. Similarly, designing and/or selecting measures that have been validated with culturally and linguistically diverse samples will improve the utility of findings and reduce spurious or null effects. More contextually informed methodologies will lead to improved generalizability and practical applications of findings. We offer concrete guidance regarding how to increase the social ecological perspective within adult autism research as it relates to study conceptualization, methodology, and measurement.
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Affiliation(s)
- Kristin A Long
- Department of Psychological & Brain Sciences and Boston University, Boston, Massachusetts, USA
| | - Monica Gordillo
- Department of Psychological & Brain Sciences and Boston University, Boston, Massachusetts, USA
| | - Gael I Orsmond
- Department of Occupational Therapy, Boston University, Boston, Massachusetts, USA
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McCauley JB, Pickles A, Huerta M, Lord C. Defining Positive Outcomes in More and Less Cognitively Able Autistic Adults. Autism Res 2020; 13:1548-1560. [PMID: 32851813 DOI: 10.1002/aur.2359] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/19/2020] [Accepted: 06/27/2020] [Indexed: 02/03/2023]
Abstract
Identifying positive outcomes for a wide range of intellectual abilities in autism spectrum disorder (ASD) remains a challenge. Several past studies of autistic adults have used outcome definitions that do not reflect the experiences of less cognitively able adults. The aim of the current study was to (1) define three domains of outcomes: autonomy, social relationships, and purpose, and (2) examine how these outcomes relate to concurrent aspects of adult functioning. Using data from a longitudinal sample of 126 adults (85% diagnosed with ASD at some point), mean age 26, who first entered the study in early childhood, we generated distinct outcomes for less (daily living skills above an 8-year-old level, having regular activities outside the home, and social contacts outside the family) and more cognitively able adults (living independently, having paid employment, and at least one true friend). Verbal IQ, assessed in adulthood, was a significant predictor of more outcomes achieved for individuals within more and less cognitively able groups. For less cognitively able adults, having ever received a formal ASD diagnosis (in contrast to current Autism Diagnostic Observation Schedule [ADOS] CSS scores) was associated with lower odds of positive outcomes. For more cognitively able adults, living skills and happiness measures were positively associated with number of outcomes met; higher ADOS CSS, internalizing and externalizing symptoms, being racially diverse, and having caregiver education below college graduation were all negatively associated with the number of positive outcomes. Tailoring outcomes to ability levels may lead to better identification of goals and service needs. LAY SUMMARY: This article describes the outcomes of autistic adults who are more and less cognitively able. For less cognitively able individuals, an earlier autism diagnosis was negatively related to outcomes. Several factors that were associated with positive outcomes for more cognitively able individuals, including daily living skills, fewer mental health problems, family demographics, and subjective measures of happiness. Our study identifies several important factors for families, individuals, and service providers to consider and discuss when planning the transition to adulthood. Autism Res 2020, 13: 1548-1560. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- James B McCauley
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, California, USA
| | - Andrew Pickles
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marisela Huerta
- Centre for Autism and the Developing Brain, Weill Cornell Medicine, New York City, New York, USA
| | - Catherine Lord
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, California, USA
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Nord D, Grossi T, Andresen J. Employment Equity for People With IDD Across the Lifespan: The Effects of State Funding. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:288-300. [PMID: 32750715 DOI: 10.1352/1934-9556-58.4.288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
In the last decade, major strides have been made to elevate the importance of employment for people with intellectual and developmental disabilities (IDD). Despite progress, improvement in employment outcomes remain modest. Using extant data, a sample of 9,871 adults with IDD accessing Medicaid Home and Community-Based Services waiver services across 33 states were studied using hierarchical modeling to understand the effects of age on employment as well as assess how state fiscal effort toward integrated employment services affects employment equity across the lifespan. Key findings showed young and older adults experienced the lowest employment outcomes. The effects of age, however, were moderated in states with higher fiscal effort to integrated employment services. Implications for research, policy, and practice are discussed.
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Affiliation(s)
- Derek Nord
- Derek Nord, Teresa Grossi, and John Andresen, Indiana Institute on Disability and Community at Indiana University
| | - Teresa Grossi
- Derek Nord, Teresa Grossi, and John Andresen, Indiana Institute on Disability and Community at Indiana University
| | - John Andresen
- Derek Nord, Teresa Grossi, and John Andresen, Indiana Institute on Disability and Community at Indiana University
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31
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Khayatzadeh-Mahani A, Wittevrongel K, Petermann L, Graham ID, Zwicker JD. Stakeholders' engagement in co-producing policy-relevant knowledge to facilitate employment for persons with developmental disabilities. Health Res Policy Syst 2020; 18:39. [PMID: 32303228 PMCID: PMC7164207 DOI: 10.1186/s12961-020-00548-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 03/17/2020] [Indexed: 11/24/2022] Open
Abstract
Background Persons with developmental disabilities (PWDD) face a number of individual, environmental and societal barriers when seeking employment. Integrated knowledge translation (IKT) involves ongoing and dynamic interactions between researchers and stakeholders for the purpose of engaging in mutually beneficial research to address these types of multi-faceted barriers. There is a knowledge gap in the IKT literature on effective stakeholder engagement strategies outside of the dissemination stage to inform policy. In this paper, we report on a number of engagement strategies employed over a 2-year period to engage a wide range of stakeholders in different stages of an IKT project that aimed to investigate the ‘wicked’ problem of employment for PWDD. Method Our engagement plan included multiple linked strategies and was designed to ensure the meaningful engagement of, and knowledge co-production with, stakeholders. We held two participatory consensus-building stakeholder policy dialogue events to co-produce knowledge utilising the nominal group technique and the modified Delphi technique. A total of 31 and 49 stakeholders engaged in the first and second events, respectively, from six key stakeholder groups. Focused engagement strategies were employed to build on the stakeholder dialogues for knowledge mobilisation and included a focus group attended only by PWDD, a stakeholder workshop attended only by policy/decision-makers, a webinar attended by human resources professionals and employers, and a current affairs panel attended by the general public. Results Our findings suggest that the level of engagement for each stakeholder group varies depending on the goal and need of the project. Our stakeholder dialogue findings highlight the inherent challenges in co-framing and knowledge co-production through the meaningful engagement of multiple stakeholders who hold different ideas and interests. Focused outreach is needed to foster relationships and trust for meaningful engagement. Conclusions In addition to providing guidance on how to implement adaptable meaningful engagement strategies, these findings contribute to discussions on how IKT projects are planned and funded. More studies to explore effective mechanisms for engaging a wide range of stakeholders in IKT research are needed. More evidence of successful engagement strategies employed by researchers to achieve meaningful knowledge co-production is also key to advancing the discipline.
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Affiliation(s)
- Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada.,Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Krystle Wittevrongel
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada
| | - Lisa Petermann
- Libin Cardiovascular Institute of Alberta, Calgary, Canada
| | - Ian D Graham
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer D Zwicker
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada.
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Friedman L, Sterling A, DaWalt LS, Mailick MR. Conversational Language Is a Predictor of Vocational Independence and Friendships in Adults with ASD. J Autism Dev Disord 2019; 49:4294-4305. [PMID: 31338717 PMCID: PMC7011355 DOI: 10.1007/s10803-019-04147-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder, impacting social communication and in some individuals, aspects of language such as vocabulary diversity. However, we have only a limited understanding of the verbal language abilities of adults with ASD. The present longitudinal study examined conversational language and its impact on vocational independence and friendship status measured 5 years later in a sample of 84 adults with ASD. After controlling for IQ and childhood language, vocabulary diversity (a measure of structural language) predicted vocational independence and having friendships, while topic maintenance (a measure of social communication) predicted friendships. These findings highlight the importance of adult conversational language abilities for adult outcomes and quality of life.
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Affiliation(s)
- Laura Friedman
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA.
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, 53705, USA.
| | - Audra Sterling
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Leann Smith DaWalt
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Marsha R Mailick
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
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Characteristics of Young Adults with Autism Spectrum Disorder Performing Different Daytime Activities. J Autism Dev Disord 2019; 49:542-555. [PMID: 30151782 PMCID: PMC6373303 DOI: 10.1007/s10803-018-3730-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Daytime activity, in terms of engagement in an occupation or education, is highly important for individuals with autism spectrum disorder (ASD), regardless of their level of functioning. In this nationwide survey, the parents of young adults diagnosed with ASD in childhood (n = 1266) provided information about the current daytime activity of their child, as well as behavioral characteristics, comorbidity, history of schooling during primary and secondary school, and availability of support. The young adults without a regular daytime activity constituted approximately one-fifth of the sample and had more behavioral difficulties and comorbidities than young adults with a daytime activity. Intellectual disability, part-time job, history of schooling, including type of school, and availability of support were found to be associated with daytime activity.
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Tomaszewski B, Smith DaWalt L, Odom SL. Growth mixture models of adaptive behavior in adolescents with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1472-1484. [PMID: 30525941 DOI: 10.1177/1362361318815645] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined growth trajectories of teacher-reported adaptive behavior in a diverse sample of adolescents with autism spectrum disorder. The participants were 244 adolescents between the ages of 14 and 21 years who were assessed at up to four time points across two and a half years of high school. Demographic variables (age, sex, race, maternal education), phenotypic characteristics (intelligence quotient, autism severity) and school factors (location of the school, school quality) were collected. Growth mixture modeling was used to identify distinct classes of growth trajectories in communication, daily living skills, and socialization domains of adaptive behavior. Two distinct classes were identified for each domain. The first class had moderately low adaptive behavior scores and demonstrated growth of adaptive behavior over time and the second class had low adaptive behavior scores and did not demonstrate change over time. Adolescents within the moderately low adaptive behavior classes were younger at enrollment in the study, had higher IQs, and lower autism symptom severity. Logistic regressions were performed, and aspects of school quality predicted the likelihood of being in the moderately low classes above and beyond autism symptoms.
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Vogus TJ, Taylor JL. Flipping the script: Bringing an organizational perspective to the study of autism at work. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 22:514-516. [PMID: 29807439 DOI: 10.1177/1362361318776103] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Taylor JL, DaWalt LS. Brief Report: Postsecondary Work and Educational Disruptions for Youth on the Autism Spectrum. J Autism Dev Disord 2018; 47:4025-4031. [PMID: 28889215 DOI: 10.1007/s10803-017-3305-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined vocational/educational disruption in the 2-3 years after high school for 36 youth with autism spectrum disorder (ASD). Data were collected three times from parents: during youth's last year of high school and two times after high school exit. Data were coded into categories indicating any versus no disruptions in postsecondary vocation/education, and group differences in individual (behavior problems, IQ, adaptive behavior, autism severity, stress reactivity) and family (parent depression, anxiety, quality of life; family income and climate) factors were examined. One-half of youth had experienced a postsecondary vocational/educational disruption; parents of those with a disruption had more depressive and anxiety symptoms and lower quality of life while their son/daughter was still in high school.
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Affiliation(s)
- Julie Lounds Taylor
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. .,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, PMB 40 - 230 Appleton Pl., Nashville, TN, 37203, USA.
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Lounds Taylor J. When is a good outcome actually good? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 21:918-919. [DOI: 10.1177/1362361317728821] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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